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INFORMATION and FORMS

To confirm your appointment, please send an email to:
amy@pacwomens.com



First-Time Visitors

We at Pacific Women's are delighted to be your OB/GYN health care providers and thank you for scheduling an appointment with us.

Please fill out the following forms, you may download them and fill them out in advance to save you time.  These forms may be completed in the office; however we must ask that you arrive early to allow time to complete the paperwork. 

Please arrive at least 20 minutes before your first appointment so we can ensure that everything is in order and that you will have the maximum amount of time with your provider during your appointment.

Hours and Scheduling

Monday-Friday 8:30am to 5pm , office closed for lunch from 12 - 1pm.

The office has an on-call service for after-hours and weekend emergencies. Please call our regular office line and listen to the prompts to call in the event of an after-hours emergency.

If you have a life-threatening emergency, please call 911 or go to the nearest Emergency Room. It is important that you contact your physician within 24 hours of receiving emergency care. The answering service is designed to help patients with URGENT medical illnesses or prenatal concerns. General advise should be given during regular visits with your provider.

Scheduling Changes

We believe in the value of your time and strive to be as prompt as possible.  However, the nature of our specialty entails occassional unforseen emergencies and deliveries that can cause schedule delays. Should this occur, we will keep you informed and see you expeditiously. You may be asked to see the nurse practitioners in these occasions but we ask for your patience and understanding. Please refer to our nurse practitioner page to learn more about what nurse practitioners do.

We try to accommodate patients arriving late, but there may be a wait while we see patients who arrived on time. In some instances, patients who arrive more than 15 minutes late may be asked to see a nurse practitioner or reschedule. Please call if you are running late to see if your doctor/NP will still be able to accommodate you.

We ask that if you need to cancel an appointment, you call us as soon as possible. There is a fee for cancellations less than 24 hours from your appointment time. Advance notice allows us to offer the available time to the next person on our waiting list. Please note this fee is not covered by health plans. 

NOTE! We have two entrances to our office suite!

·  Suite 316 (Main Office)- Drs. Green, Moy, Hom, Chan, Kaul, Haessler, and the nurse practitioners

·  Suite 312 - Drs. Bason-Mitchell and Lofquist

Please confirm the location for your appointment.

Registration, Check-In and Check Out

Please present the front desk receptionist with a copy of your current insurance card at each visit. Please inform our staff if there have been any changes in your home address, phone number, email and insurance coverage. This helps ensure that your files is always kept up to date, and that we always have current billing information.

Please stop at the check-out desk to receive the paperwork from your visit, to make follow up appointments and to pay your co-pay. We must collect assigned co-pays and other appropriate fees at the time of your visit.


Insurance and Payment

We are contracted with most major insurance companies under the PPO network and are ONLY contracted with Brown and Toland Medical Group under the HMO network. We are also contracted with Medicare. Please note we are not providers of Medi-Cal, San Francisco Health Plan or any subsidiary of Medi-Cal state programs.

If you intend to pay out of pocket, we accept cash, checks, MasterCard and Visa. Please be prepared to pay for your service at the time it is rendered.

Blue and Gold Insurance Plans

UCSF EMPLOYEES WITH "BLUE & GOLD" INSURANCE PLAN:  YES, you CAN stay with our practice on your new plan!

Pregnancy/obstetrics:  
If you have had your first obstetrics (prenatal) appointment by December 31, 2012, you may stay with our practice and deliver at CPMC, even if your due date is in August, 2013.   You will incur no additional costs.  We will facilitate the necessary paperwork for you to switch to Hill Physicians but stay with our practice and CPMC!

Annual examinations/other gynecological issues:
If you switch to Hill Physicians, we recommend two options:
 
1) See Dr. Elizabeth Moy, a Hill Physicians member, for your 2013 annual;
2) For a nominal fee (far less than a single month of the additional premium required to stay with Brown and Toland), you may still see your own doctor in the practice.  All tests and images (sonograms, mammograms, blood work) will be sent to "in network" labs and imaging centers, so you would not bear any additional costs for any tests we might order.
 
We are hopeful that new contracts will be available in 2014 so that patients have more choices!   Please feel free to contact Harriet at 415-379-9600 orharriet@pacwomens.com if you have questions or need assistance


HMO Insurance

We are proud to be members of the Brown and Toland Medical Group (BTMG), our independent physician affiliation.

If you are currently a member of a different IPA (for example Marin IPA or Mills Peninsula IPA) AND have straight HMO insurance (not "point of service") your plan will not cover your visit.

Because Brown and Toland Medical Group (BTMG) offers the advantage of both university and community physicians, we recommend that our patients switch affiliation to Brown and Toland. We are happy to assist you in finding a primary care doctor within BTMG. You may switch medical groups the first of any month.

PPO Insurance

If we are participating providers in your PPO plan, our fees are paid in accordance with your pre-arranged benefit package (with deductibles, co-pays, etc.). Please be sure you know which laboratories and radiology units are also participating members so that we may refer you to the appropriate resources.

Because some health plans restrict our ability to provide you the type of care we value, the physicians of PWOG have declined "preferred provider" status with a few small PPO health plans 

If we are not participating providers in your plan (i.e. "out of network"), you may be asked to pay for physician services "up front". We will provide the necessary paperwork for you to seek reimbursement from your insurance. In almost all instances, your insurer still pays a large portion of physician fees. In some cases, your out of pocket costs actually drop! Either way, the patient's out of pocket costs are usually quite nominal. We expeditiously refund your initial payment as soon as insurance compensation is received.

Because we refer you to "in network" providers for lab work, radiology (ultrasound, bone densities, mammograms, etc), and hospitalization, your co-pays for these services are unaffected even though we are out of network.

Medicare

While we are participating providers of the Medicare plan, please note that Medicare does not pay for all your healthcare costs. You should be aware Medicare will not pay for Preventative Well-Woman visits, as it does not meet the definition of any Medicare benefits. Medicare covers the costs of your Pap smear once every 24 months.

If you have questions or need further clarification on insurance coverage our billing company at 415-972-4500 is happy to assist you.  


Additional Information

We will be happy to provide you, upon written request copies of your file with Pacific Women’s OB/GYN Medical Group.  A copy charge will be incurred and if your file must be retrieved from storage, you will be charged our costs for retrieval as well.

Due to escalating administrative costs, we must charge a $15.00 fee for completing each disability form. This fee includes postage.